NPI | 1457731440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology (Licence: LA 328000) |
Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: AL MD.39360) |
Enumeration Date | 2015-06-04 |
Last Update Date | 2024-07-16 |